Abstract
BackgroundIn arthroscopic surgery, the suture anchor technique has become popular for rotator cuff repair. Preoperative evaluation of the bone microstructure is of utmost importance because, especially in elderly patients, osteoporotic changes may cause anchor pullout, which results in failure of rotator cuff repair. Many groups have reported humeral microstructural analysis; however, most studies were experiments using porcine specimens or human cadavers. In this study, we used multidetector row computed tomography to successfully perform in vivo evaluation of the bone microstructure of the humeral greater tuberosity in patients with rotator cuff tears.MethodsTen patients were examined. Regions of interest were defined in six quadrants of the greater tuberosity (medial, lateral, and far lateral rows of the anterior and posterior areas). The local bone mineral density and the trabecular microstructural parameters, including the mean bone volume to total volume (BV/TV), trabecular thickness, trabecular separation, and structure model index (SMI), were measured using bone analysis software.ResultsThe BV/TV of the posteromedial region was highest and the SMI of the posteromedial region was lowest. These findings suggest that the bone quality of the posteromedial portion is the highest within the greater tuberosity.ConclusionBecause the bone quality may be correlated with the pullout strength of suture anchors, our method can help to understand the individual and regional variance in bone quality and may lead to the creation of personalized surgical protocols.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-351) contains supplementary material, which is available to authorized users.
Highlights
IntroductionThe suture anchor technique has become popular for rotator cuff repair
In arthroscopic surgery, the suture anchor technique has become popular for rotator cuff repair
The BMD in Pm was significantly highest among all Regions of interest (ROI) (Am, P
Summary
The suture anchor technique has become popular for rotator cuff repair. Preoperative evaluation of the bone microstructure is of utmost importance because, especially in elderly patients, osteoporotic changes may cause anchor pullout, which results in failure of rotator cuff repair. Many groups have reported humeral microstructural analysis; most studies were experiments using porcine specimens or human cadavers. We used multidetector row computed tomography to successfully perform in vivo evaluation of the bone microstructure of the humeral greater tuberosity in patients with rotator cuff tears. There are two main rotator cuff repair methods: the suture anchor technique and the. Many groups have reported that the bone quality of the humerus is correlated with the pullout strength of suture anchors [8,12,13,14]. The applicability of these findings are limited, because all of these studies were performed only using porcine specimens or human cadavers
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